Lisa T. Prodigalidad1, Yoav Peled2, Stuart L. Stanton1, Haim Krissi2
1Department of Pelvic Reconstruction and Urogynecology, St George's Hospital, London, UK
2Urogynecology Unit, Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Petach Tikva, Israel
Tóm tắt
AbstractObjectiveTo evaluate the incidence of prolapse and prolapse‐related symptoms following vaginal hysterectomy.MethodsData were reviewed from women who underwent vaginal hysterectomy between 1988, and 1995, at St George's Hospital, London, UK, and attended long‐term follow‐up. Outcome measures included a questionnaire for prolapse, urinary, bowel, and sexual symptoms; and a vaginal examination.ResultsAmong 94 women attending long‐term evaluation, the mean follow‐up time was 100.7 months (range 67.0–156.0 months). Before vaginal hysterectomy, urgency was noted among 23 (24.5%), urge incontinence among 11 (11.7%), and stress incontinence among 8 (8.5%) women. At follow‐up, these symptoms were observed among 23 (24.5%), 13 (13.8%), and 6 (6.4%) women, respectively. De novo urge incontinence and de novo stress incontinence were observed among 3 (3.2%) and 2 (2.1%) women, respectively. Vaginal examination data were compared for 70 women, of whom 18 (25.7%) had grade 1, 40 (57.1%) had grade 2, and 6 (8.6%) had grade 3 uterine prolapsed before surgery. Postoperatively, vaginal vault prolapse occurred in 7 (10.0%) women and correlated with degree of posterior prolapse (P = 0.007), but not with severity of uterine descent (P = 0.205) or previous prolapse surgery (P = 0.573).ConclusionThe incidence of post‐hysterectomy vault prolapse correlated with the degree of preoperative rectocele.
